whole content of OSCE and OSPE

1. J.G COLLEGE OF NURSING,
AHMEDABAD.
SUB: Nursing Education
TOPIC:OPSE/OSCE
SUBMITTED TO, SUBMITTED BY,
Mr. P Yonatan, Ms.Sonal Patel,
Asst. Professor, F.Y.M.Sc(N),
J.G College of Nursing, J.G College of Nsg,
Ahmedabad. Ahmedabad.

3. OBJECTIVE STRUCTURED
PRACTICAL
EXAMINATION (OSPE)

4.  Introduction
The term OSPE is derived from OSCE in 1975
which was later extended to practical
examination and modified by Harden and
Gleeson.
Practical examination has several problems
especially in terms of its outcome
Out of the various method adopted the OSPE
was largely tested on the basis on success of
OSCE.

5. Definition
Objective structured
practical examination
(OSPE) is a new pattern of
practical examination, in
which each component of
clinical competence is tested
uniformly and objectively for
all the students who are
taking up a practical
examination at a given place.

6. Features of OSPE
The main features of OSPE is that the
process and the product are tested
giving importance to individual
competencies.
The examination covers a broad range
of clinical skills and content much
wider than a conventional examination.
The scoring is objective, since
standards of competence are present
and agreed check lists are used for
scoring.

7. Where questions are asked in
response stations, these are always
objective. Simulations can be used for
acute cases and there is scope for
immediate feedback.
Patient variability and examiner
variability are eliminated thus
increasing the validity of the
examination.
An analytical approach to the
assessment.
Feedback to teacher and student.

9. Stations
A “station” is the site at which the student is
assessed on particular ability.
The total number of station will vary based the
number of skills, behaviors and attitudinal items
to be tested
For most clerkships or courses, the total will vary
from 10-25 (usually 20)

10. During this exam student pass through a
number of station
OSPE exam ideally consist of 15 – 20 stations
for exam of a particular course.
The time for each stations should not be less
than four minutes
Students are rotated through all the station and
move to the next station at the ring of the bell.

11. Each station is design to test experimental
competences
At some stations called procedures station
students are given task to perform on subjects
At all station there are observer with agreed
checklist to mark the student performance.
At other station called response station student
write answer of objective type question or record
their findings of the pervious procedure station

12. Set up “Stations”
Stations are of different types
History Taking stations: e.g. “This patient complains of
abdominal pain. Take a history pertaining to abdominal
pain.”
Examination stations: Student’s ability to perform a
clinical examination is assessed, e.g. “Record ankle jerk
response.”
Skill stations: Student’s are tested on their ability to
perform a skill. E.g. Provide CPR, start IV line.

13. Set up “Stations”......
Communication station: Communication ability
of a student is assessed. E.g. “Advise the mother of a
three year old child with diarrhea regarding use of
ORT for her child.”
Response stations: Interpretative ability of a
student is assessed. E.g. “interpret this Chest X ray of
a 40 year old patient with acute dyspnea and state 3
reasons for your answer”
Rest stations: To give students a chance to organize
their thoughts.

14. Duration of station
Duration of station has been fixed.
Make sure that the task expected of the
student can be accomplished within the time.
Time ranging 4 to 15 minutes. 5 minutes
station probably most frequently chosen.
The time depends on the competencies to be
assessed in the examination.

15. 1
2
34
5
 Movement in the Stations

16. Explanation of procedure and
response station by example.

17.  Check List
1.Explain to subject what he is going to do.
2.Applies the pressure cuff correctly.
3.Ask the subject to sit comfortably.
4.Keep the bell of stethoscope correctly on capital
fosse.
5.Deflates the pressure from the cuff properly.
6.Take care to repute to the procedure to insure
correct reading of systolic and diastolic pressure.
7.Thanks subject at the end of recording.
8.Reset the instrument and closes it down properly.

18. Advantages of OSPE
 1. It is useful for any subject.
 2. It can also examine both the clinical and
Experimental skills.
 3. Checklists are used for marking and evaluation.
 4. Student take more interest due to verity and keep
themselves alert during the whole process.
 5. Exam is modified easily as per institutional
circumstances.
 6. Large no of students can be tested with in the short
time.

19. Disadvantages of OSPE
1. If proper planning, briefing to the
student, preparation of procedure of
response stations are not done properly
then the whole process of OSPE may
become failed.
2. Separate observer for each station is
required.
3. Costly method.

20. OBJECTIVE STRUCTURE
CLINICAL EXAMINATION
(OSCE)

22. INTRODUCTION:
An OSCE is a modern type of examination
often used in Health sciences (like Medicine,
chiropractic, physical therapy, Radiography,
Nursing, Pharmacy and Dentistry) to test
clinical skill performance and competence in
skills such as communication, clinical
examination, medical
procedures/prescription, exercise
prescription, etc.

23.  OSCE DESIGN:
Objective – all
candidates are
presented with
the same stimuli

24. What is an OSCE?
• Objective
• Structured – Specific foundational and
functional competencies are tested at
each station and the marking sachem for
each station is structured

25.  What is an OSCE?
• Objective
• Structured
• Clinical Examination – Test of
performance of clinical competencies,
with an emphasis on skills and
attitudes

26. Definition
An Objective Structured Clinical Examination
(OSCE) is a modern type of examination often
used in health sciences (e.g. medicine, ,
physical therapy, radiography, nursing,
pharmacy, ) to test clinical skill performance,
and competence in skills such as
communication, clinical examination, medical
procedures / prescription, exercise
prescription, and interpretation of results.

27. Objective
All candidates are assessed using exactly the same
stations (although if real patients are used their signs
may vary slightly) with the same marking scheme. In
an OSCE candidates get marks for each step on the
mark scheme that they perform correctly which
therefore makes the assessment of clinical skills more
objective rather than subjective, where one or two
examiners decide whether or not the candidate fails
based on their subjective assessment of their skills.

28. e.g. A simple model of the skin can be
used to enable the student to demonstrate
how to give an I/M injection.
 To set the scene at the beginning of
each station, the student will be given a
short scenario to read. This will provide
the information necessary to establish
the context in which the specific set of
skills in to be performed and will
identify the skills being examined.
NEED OF OSCE:

29.  METHOD & STATION : TWO TYPES
 PROCEDURE STATION
 e.g. Taking history of a patient
 Examine this patient’s pulse
 QUESTION STATION
•MCQs related to finding
•Interpretation of temperature chart

30. Characteristics of OSCE:

31. The main features of OSCE/OSPE is that both the process and
the product are tested giving importance to individual
competencies. The examination covers a broad range of
clinical skills much wider than a conventional examination.
The scoring is objective, since standards of competence are
preset and agreed check lists are used for scoring. Where
questions are asked in response stations, these are always
objective. Simulations can be used for acute cases and there is
scope for immediate feedback. Patient variability and examiner
variability are eliminated thus increasing the validity of the
examination.
Features of OSCE

32. In an OSCE, clinical skills are tested
rather than pure theoretical
knowledge. It is essential to learn
correct clinical methods and then
practice repeatedly until one perfects
the methods.
 Marks are awarded for each step in
the method; hence, it is essential to
dissect the method into its individual
steps, learn the steps, and then learn
to perform the steps in a sequence.
 Preparation

33. Most universities have clinical skills labs
where students have the opportunity to
practice clinical skills. It is often very
helpful to practice in small groups with
colleagues, setting a typical OSCE
scenario and timing it with one person
role playing a patient, one person doing
the task and (if possible) one person either
observing and commenting on technique
or even role plating the examiner using a
sample mark sheet. In doing this, the
candidate is able to get a feel of running to
time and working under pressure.

34.  Miller (1990) recommends that, in order to
demonstrate competency, ‘knows’, ‘knows
how’, ‘shows how’ and ‘does’ are necessary.
This means that, in terms of demonstrating
clinical competency, knowledge (knows),
competence (knows how), demonstration
(shows how) and clinical performance (does)
are all important.
Knowing, Showing, Doing, e.g. Pain
Assessment

35. ORGANISATION OF OSCE
A.ADVANCE PLANNING
B.ORGANISATION THE DAY BEFORE EXAMINATION
C.THE DAY OF EXAMINATION
D.AFTER THE EXAMINATION
A. Advance Planning :
Time ideally 6 months for major examination 8 weeks for
formative.

36.  Advantages of OSCE
Students were appraised about their performance.
It also highlighted the need for clinical supervision.
The students were evaluated on objectives in clinical
competence based on set criteria.
It gave the faculty the opportunity to differentiate the high
with the low performance objectively.
Skills in applying principles were assessed and students also
learnt at the same time.

37. All students could be assessed within 90 minutes, which
was less than the time taken for traditional practical
examination (3 hrs).
Students were provided opportunity to apply principles,
interpret data and effective time management was
provided, several skills were assessed at the same time.
It was student-centered approach.

38.  DISADVANTAGES
1. Knowledge and skills tested in COMPARTMENTS, not for ability to look
at the patient as a whole. Can combine with traditional type ‘Long Case’ to
overcome.
2. DEMANDING for examiners and patients – use more patients/ simulated
patient.
3. TIME taken for planning in advance greater than traditional examination.
More effort and time are required before examination.
Can reduce with
a) Experience and
b) Bank of objective test items & checklist.

41. BIBLIOGRAPHY
1. Elakkuvana Bhaskara Raj.D, “Text Book of Nursing
Education” EMMESS Medical Publishers, Second
Edition,2015,
Page No: 266 to 269
2. R Sudha, “Principles and Concepts of Nursing
Education” Jaypee Brothers Medical
Publishers(p)LTD, First Edition,2013,
Page No:181 to 188
3. www.slideshare.com